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How Do We Prepare for the Worst? The Story of the Disaster Recovery Case Management Standards

How Do We Prepare for the Worst? The Story of the Disaster Recovery Case Management Standards

Editor’s note: The following article is based on information shared during a Panel Session titled From Columbine to Parkland: A Conversation About School Violence the National Council for Behavioral Health 2018  in Washington, DC.

Content Warning: This post discusses active shooter incidents, including the recent one at Marjory Stoneman Douglas High School and Sandy Hook Elementary School. The author would also like to make it clear that the prevention briefly mentioned is not necessarily mental health treatment. While there is no denying that more comprehensive mental health treatment is needed for the general population, only 22% of mass shootings involve someone who could be considered to have a mental illness. Connecting mental illness and active shooters only furthers the stigma. 

An ounce of prevention is worth a pound of cure. No one knows that better than those of us who work in human services, though unfortunately more often times than not we are called in to help long past the time of prevention. A big part of the job is triaging, we can’t always prevent the worst, but we can prepare for it. Henderson Behavioral Health prepares for the worst through its disaster relief services, for the most part aiding victims of hurricanes. Henderson’s CEO, Steven Ronik, noted in a panel at the National Council for Behavioral Health’s National Convention, “the kind of disasters we are used to are hurricanes.” But on February 14, 2018, Henderson’s services were needed for a different kind of disaster, at Stoneman Douglas High School in Parkland, Florida. 

Mass Shootings are on the rise. Looking at the time period of 2000 to 2015, active shooter incidents have more than doubled in the second half of that period. The solution for this is hotly contested, with both sides digging their heels in the ground leaving us at a standstill and while it may offer us that inch of prevention we so desperately need, reeling communities are currently in need for pounds and pounds of cure. The purpose of COA’s Disaster Recovery Case Management standards is to support an organization’s ability to coordinate the necessary resources to help communities create a sustainable recovery. 

Mental Health and the Legacy of
a Mass Shooting

A mass shooting is like a “psychological nuclear bomb,” according to Dr. John Santopietro, who coordinated the crisis response after Sandy Hook, and following the blast is “psychological, toxic radiation” that is the job of mental health workers to help clean up. The closer you get to the blast site (individuals who were at the mass shooting, families, the communities), the more toxic psychological waste there is to clean up. 

That psychological waste can take a number of different forms, including a rise in substance abuse, depressive symptoms, and risk-taking behaviors. It’s not going to always be as easy.  James Adams, Executive Director of the Geauga County Board of Mental Health and Recovery Services and the coordinating lead following Chardon High School, talks about the rise in traffic-related accidents and violations he saw after the active shooter incident and he continues to see every year around the anniversary. Even though the community has put some distance between itself and the incident, the psychological trauma still radiates throughout.

Lessons Learned

April 20th of this year marks the 19th anniversary of the Columbine shooting. Dr. Harriet Hall, CEO of Jefferson Center for Mental Health Wheat Ridge, Colorado, remembers a time when there were no protocols for how to handle an active shooter incident. Through her leadership and swift action, she organized funds to provide comprehensive mental health care for the community even after the event itself, including resources for her staff. Harriet Hall, to this day, remains an example of strong leadership in the face of adversity and someone who operates from a trauma-informed lens. Some of her innovative work included coordinating and collaborating with mental health organization throughout all of the communities and counties affected by the tragedy and creating drop-in centers- places for people to go to talk to professionals or learn about resources if they wanted to but without obligation.

Some other advice for preparing for disaster include:

  • Find a system for vetting professionals
  • Think outside of the box of the important roles needed- sometimes having someone monitoring social media can be a big influence in terms of deploying help at crucial junctures
  • Have a plan and capabilities for an increase in mobile crisis response teams
  • Understand the funding landscape 
  • Consider all potentially affected populations- following the Chardon High School active shooter incident, the first people to reach out to the crisis lines for help were Vietnam veterans who were triggered; who else in your community might this trigger?

Nobody wants to be in the position of coordinating these services, in all of our hopes we never will. But we might. And even if it’s not a mass shooting, we should take into consideration all the ways in which trauma ripples through our communities and how Disaster Recovery Services might be needed. COA’s DRCM standards help an organization prepare so that when they are in the midst of a psychological blast, they can focus on the work that needs to be done instead of hammering out the minutiae of how to do it.

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